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22 - Case Formulation for Complexity and Comorbidity in Anxiety Disorders and Depression

from Part Five - Complexity and Comorbidity in Anxiety Disorders and Depression:

Published online by Cambridge University Press:  06 January 2022

Gillian Todd
Affiliation:
University of East Anglia
Rhena Branch
Affiliation:
University of East Anglia
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Summary

Anxiety disorders and depression are the most prevalent mental disorders, and although psychological interventions (particularly CBT) have been shown to be effective, treatment response is often suboptimal, given that, in many cases, patients have complex presentations and frequent comorbidities. Especially in such cases, a good case formulation is essential. Case formulation derives from the initial assessment and guides intervention by conceptualizing the presenting symptoms, the underlying etiological mechanisms, and their origin. A good conceptualization should successfully inform treatment and should be evidence-based, combining research data with personalized features of each case. According to the level of analysis, we can distinguish between case, diagnosis/presenting problem formulation, and symptom level/specific problem formulation. For complex and comorbid depression and anxiety disorders, we should include additional elements and also select the most appropriate conceptualization model for our particular case.

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